Assessment & Research

A preliminary examination of brain morphometry in youth with Down syndrome with and without parent-reported sleep difficulties.

Lee et al. (2020) · Research in developmental disabilities 2020
★ The Verdict

Sleep problems in Down syndrome may shrink measurable brain volume, so screen and treat sleep first.

✓ Read this if BCBAs running clinics or schools programs for youth with Down syndrome.
✗ Skip if Practitioners who only serve typically developing clients or adults without sleep issues.

01Research in Context

01

What this study did

Lee et al. (2020) scanned the brains of youth with Down syndrome.

Parents also answered questions about their kids’ sleep.

The team compared kids whose parents reported sleep problems with kids who slept well.

02

What they found

Kids with Down syndrome plus sleep troubles had smaller whole-brain volumes.

Several brain regions were also reduced when compared with DS peers who slept well.

The gaps were large enough to see on a clinical MRI.

03

How this fits with other research

Tassé et al. (2013) already showed that poor sleep predicts weaker executive function in teens with DS.

The new study adds a reason: less brain tissue.

Hong et al. (2021) meta-analysis proves executive skills are a major weakness in Down syndrome.

Together the papers form a chain: bad sleep → smaller brain → weaker EF.

Bao et al. (2017) saw a similar link in autism—smaller brainstem tied to aggression—showing the MRI-behavior pattern crosses diagnoses.

04

Why it matters

If you serve clients with Down syndrome, add two sleep questions to your intake.

A simple parent checklist can flag kids who need a medical sleep work-up.

Treating sleep may protect both brain growth and the executive skills you target in therapy.

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Add a 2-item parent sleep-rating scale to your intake packet and review results before writing EF goals.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
48
Population
down syndrome
Finding
negative

03Original abstract

BACKGROUND: Down syndrome is associated with poor sleep but little is known about its neural correlates. AIMS: The current research compared brain morphometry in youth with Down syndrome with parent-reported sleep problems (DS-S) to peers with Down syndrome (DS) and typical development (TD) without parent-reported sleep problems matched on age (M = 15.15) and sex ratio (62 % female). METHODS AND PROCEDURES: Magnetic resonance imaging was completed on a 3 T scanner. Participants were stratified into groups based on parent-report: DS-S (n = 17), DS (n = 9), TD (n = 22). Brain morphometry, processed with the FreeSurfer Image Analysis Suite, was compared across groups. In addition, the co-occurrence of medical conditions in the DS groups was examined. OUTCOMES AND RESULTS: Youth with DS-S had reduced total, frontal, parietal, and temporal brain volumes relative to DS and TD peers. They also had higher rates of congenital heart defects than the DS-only group; however, this comorbidity did not appear to account for morphometry differences. CONCLUSIONS AND IMPLICATIONS: Parent-reported sleep problems in DS appear to relate to global and localized volume reductions. These preliminary results have implications for understanding the neural correlates of poor sleep in DS; they also highlight the importance of examining relations between sleep and other medical comorbidities.

Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103575